Prescription Benefit Specialist

Company Name:
Express Scripts
Advance your career with the company that makes it easier for people to choose better health.
Express Scripts is a leading healthcare company serving tens of millions of consumers. We are looking for individuals who are passionate, creative and committed to creating systems and service solutions that promote better health outcomes. Join the company that Fortune magazine ranked as one of the "Most Admired Companies" in the pharmacy category. Then, use your intelligence, creativity, integrity and hard work to help us enhance our products and services. We offer a highly competitive base salary and a comprehensive benefits program, including medical, prescription drug, dental, vision, 401(k) with company match, life insurance, paid time off, tuition assistance and an employee stock purchase plan.
The mission of Client Services is to meet market needs for speed, flexibility and reliability, while driving and influencing best operational practices to make Express Scripts the most competitive and effective PBM.
Client Services includes Client and Benefit Administration, Manual Claims Processing, Eligibility, Quality Control, Implementation and the Client Service Center. These centralized functions support the client lifecycle throughout the enterprise to help Express Scripts "get it right the first time" to increase client satisfaction and reduce waste and the cost of rework.
Handle inbound calls and facilitate outbound calls from/to Patients inquiring about their Home Delivery benefit. Explain the advantages of Home Delivery prescription services (mail order). Identify patient needs and present savings and convenience of receiving medications via Home Delivery. Accurately complete and document patient interactions and transactions in company databases.
Initiate calls and faxes to prescribers to obtain prescriptions on behalf of patients who agree to use Home Delivery. Contact prescribers to create awareness of their patient's request to fill their prescriptions via home delivery pharmacy and submit for processing. Effectively manage a caseload of records to facilitate timely processing of Home Delivery prescription requests.
Member (Patient): Utilizing a consultative sales approach, explain the advantages of Home Delivery prescription services (mail-order). Update conversion requests and provide shipment status to members.
Physician: Facilitate transition of requested medications to Home Delivery. Advocate for the member patient by placing phone calls, fax or other means to prescriber's offices to obtain prescriptions; forward to pharmacy for fulfillment. Obtain new prescriptions from prescriber's offices and record approval status. Manage daily workflow volume. Evaluate prescription status determine next steps and record outcome. Service incoming calls from doctors' offices.
Both: Ensure accurate and complete documentation is entered into the appropriate systems for all contacts (internal/external) to maintain the quality of the home delivery process, document HIPAA compliance and reduce potential legal concerns. Navigate multiple on-line systems to capture and interpret basic patient/physician information and document the information in company data systems. Resolve questions and/or issues that may be preventing shipment of an order. Uphold quality and productivity standards on all transactions. Work collaboratively with other MCC employees to ensure that best practices are shared. Special projects and other duties as assigned.
Formal Education and/or Training:
High school diploma or equivalent
Years of Experience:
2 - 3 years of customer service experience or customer-facing experience.
Be registered or registry eligible through the appropriate state's board of pharmacy (if required by state law) upon hire or transfer; Must have ability to maintain active licensure throughout time in position
Computer or Other Skills:
General knowledge of Microsoft Outlook and Internet with the ability to navigate through multiple computer systems simultaneously
Knowledge and Abilities:
Good verbal and written communication skills; Ability to articulate in communicating prescription request clearly; Ability to provide exceptional listening and customer service skills; Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions; Demonstrate dependability, self-motivation and goal-orientation; Ability to positively represent ESI's vision and values when interacting with customers and members; Detailed oriented; Ability to work a flexible schedule including weekends
Express Scripts is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation. Express Scripts is a VEVRAA Federal Contractor.
Job Category: Operations
Primary Location: United States-Ohio-Mason
Work Locations: Mason, OH - 8990 Duke Blvd (4603)8990 Duke DriveMason, 45040
Schedule: Full-time
Shift: Any
Employee Status: Regular
Travel: No
Work From Home?: No

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.